Health Plan Operations Supervisor

A company is looking for a Health Plan Claims Lead.

Key Responsibilities

Support operational aspects of service area and product expansions

Inspect and review claims processing quality, providing feedback to TPA

Manage TPA operations to ensure quality service delivery and compliance

Required Qualifications

Bachelor's degree or 6+ years of relevant healthcare operation experience

Four years of experience managing healthcare operation teams

Strong knowledge of ACA / IFP and commercial claim requirements

Experience in oversight management of TPA operations for claims

Background in developing and reviewing operational SOPs and business requirement documents